疏肝健脾法对产褥期抑郁肝郁脾虚证影响的临床研究

发布时间：2018-03-23 03:35

本文选题：产褥期　切入点：抑郁症　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:以疏肝解郁、养血健脾之法创制安产解郁汤治疗产褥期抑郁症肝郁脾虚型患者,探讨其临床应用价值。方法:研究对象选自长春中医药大学附属医院脑病科门诊或疗区收治的产褥期抑郁症患者。研究资料收集时间为2014年1月至2015年12月。共纳入72例患者,随机分为研究组、对照组各36例。研究组采用安产解郁汤治疗,药物组成:柴胡10g、川芎10g、白芍15g、枳壳10g、陈皮10g、香附5g、当归15g、炮姜10g、茯苓15g、白术15g。用法:采用本院农本方颗粒装入医用胶囊,每次6粒,每日3次,口服,连用1个月为1疗程。对照组采用舒肝解郁胶囊(成都康弘药业集团股份有限公司生产,国药准字YBZ10382008)治疗,主要成分:贯叶金丝桃、刺五加。用法用量:口服,一次6粒,一日3次,1个月为l疗程。主要的疗效指标的判定:(1)HAMD计分表;(2)肝郁脾虚郁证中医症侯评分。结果:治疗后,研究组SDS评分总有效率为91.7%,显愈率为69.4%,明显优于对照组(P0.01),具有统计学意义;研究组HAMD评分总有效率为91.7%,显愈率为69.4%,明显优于对照组(P0.01),存在显著性差异;治疗后,两组患者中医症状均有所改善,除便溏和胁肋胀满疼痛,其他各中医症状研究组改善水平均优于对照组(P0.05),差异具有统计学意义;经秩和检验分析,研究组中医临床证候疗效判定总有效率为97.2%,显愈率为72.2%,明显优于对照组(P0.01),存在显著性差异。结论:以疏肝健脾为原则的中医药治疗是目前产褥期抑郁症的可行治疗方法。安产解郁汤在改善产褥期抑郁症肝郁脾虚证患者的症状和中医证候上可收获良好疗效,同时避免了长期服用抗抑郁药物可能带来的多种不良反应,有利于患者的治疗依从性。安产解郁汤在疏肝解郁的同时,还具有健脾养血之功效,有利于改善患者纳呆、消化不良、失眠多梦等症状,更好的提高患者的生存质量。
[Abstract]:Objective: to treat patients with depression of liver and spleen in puerperium with the method of soothing liver and relieving depression and nourishing blood and invigorating spleen. Methods: patients with puerperal depression were selected from the Department of Encephalopathy, affiliated Hospital of Changchun University of traditional Chinese Medicine. The data were collected from January 2014 to December 2015. A total of 72 patients were included in the study. They were randomly divided into study group (n = 36) and control group (n = 36). Drug composition: Bupleurum 10g, Chuanxiong 10g, Radix Paeoniae Alba 15g, Fructus Aurantii 10g, Chen Pei 10g, Rhizoma Atractylodes 15g, Angelica sinensis 15g, Guangjiang 10g, Poria cocos 15g, Atractylodes Atractylodes 15g.Use: take Nong Benfang granules into medical capsule, 6 capsules per time, 3 times a day, oral. The control group was treated with Shugan Jie Yu capsule (produced by Chengdu Kanghong Pharmaceutical Group Co., Ltd., YBZ10382008). The main ingredients: Hypericum perforatum, Acanthopanax senticosus. Three times a day, one month as a course of treatment. Judgment of main curative effects: 1) score of Hamd score (2) TCM syndrome of liver stagnation and spleen deficiency. Results: after treatment, The total effective rate of SDS score in the study group was 91.7, and the apparent recovery rate was 69.4, which was significantly better than that in the control group (P 0.01). The total effective rate of HAMD score in the study group was 91.7% and the obvious recovery rate was 69.4%, which was significantly better than that in the control group (P 0.01). The TCM symptoms of the two groups were improved, except loose stools and full flank pain, the improvement level of other TCM symptom study groups was better than that of the control group (P 0.05), the difference was statistically significant, and the rank sum test analysis showed that the improvement level of TCM symptoms in the study group was higher than that in the control group. In the study group, the total effective rate of TCM clinical syndromes was 97.2g and the markedly cured rate was 72.2, which was obviously superior to that of the control group (P0.01a). Conclusion: the TCM treatment based on the principle of soothing liver and invigorating spleen is a feasible treatment for depression in puerperium. In improving the symptoms and syndromes of patients with liver depression and spleen deficiency syndrome in puerperium depression, it can obtain good curative effect. At the same time, it avoids a variety of adverse reactions that may be brought about by long-term antidepressant drugs, which is conducive to the treatment compliance of the patients. While relieving the liver and relieving the depression, it also has the effect of invigorating the spleen and nourishing the blood, which is conducive to improving the patient's retention. Dyspepsia, insomnia and dream symptoms, better improve the quality of life of patients.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.4

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